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Individual
MARK GONZALES
Active
Individual
MARK GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAADC-CA LCI10970318
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCI10970318
CA
390200000X
Student in an Organized Health Care Education/Training Program
5465630291
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168767
ADDICTION COUNSELOR CERTIFICATION BOARD OF CALIFORNIA
CA
Enumeration date
11/04/2013
Last updated
03/07/2023
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